E. coli Infection

Overview

What is E. coli?

E. coli is short for Escherichia coli -- bacteria (germs) that cause severe cramps and diarrhea. E. coli is a leading cause of bloody diarrhea. The symptoms are worse in children and older people, and especially in people who have another illness. E. coli infection is more common during the summer months and in northern states.

Symptoms

What are the symptoms of E. coli infection?

Symptoms start about 7 days after you are infected with the germ. The first sign is severe abdominal cramps that start suddenly. After a few hours, watery diarrhea starts. The diarrhea causes your body to lose fluids and electrolytes (dehydration). This makes you feel sick and tired. The watery diarrhea lasts for about a day. Then the diarrhea changes to bright red bloody stools. The infection makes sores in your intestines, so the stools become bloody. Bloody diarrhea lasts for 2 to 5 days. You might have 10 or more bowel movements a day. Some people say their stools are "all blood and no stool."

You may have a mild fever or no fever. You may also have nausea or vomiting. If you have any of these symptoms -- watery, bloody diarrhea, cramps, fever, nausea or vomiting -- try to get to your doctor right away.

Causes & Risk Factors

How can I catch E. coli infection?

Most E. coli infections come from:

Eating undercooked ground beef (the inside is pink)

Drinking contaminated (impure) water

Drinking unpasteurized (raw) milk

Working with cattle

Eating food contaminated with animal feces (such as vegetables)

Healthy beef and dairy cattle may carry the E. coli germ in their intestines. The meat can get contaminated with the germ during the slaughtering process. When beef is ground up, the E. coli germs get mixed throughout the meat.

The most common way to get this infection is by eating contaminated food. You can be infected with the E. coli germ if you don't use a high temperature to cook your beef, or if you don't cook it long enough. When you eat undercooked beef, the germs go into your stomach and intestines.

The germ can also be passed from person to person in day care centers and nursing homes. If you have this infection and don't wash your hands well with soap after going to the bathroom, you can give the germ to other people when you touch things, especially food.

People who are infected with E. coli are very contagious. Children shouldn't go to a day care center until they have 2 negative stool cultures (proof that the infection is gone). Older people in nursing homes should stay in bed until 2 stool cultures are negative.

Diagnosis & Tests

How is E. coli infection diagnosed?

The diagnosis is made by finding E. coli in a stool culture. If you have bloody diarrhea, see your doctor as soon as possible. Your doctor will do a culture to find out if you have E. coli in your intestines. The culture has to be taken in the first 48 hours after the bloody diarrhea starts.

Treatment

How is the infection treated?

There is no special treatment, except drinking a lot of water and watching for complications. Don't take medicine to stop diarrhea unless your doctor tells you to. This medicine would keep your intestines from getting rid of the E. coli germ. If you are seriously dehydrated, you might need to go to the hospital to have fluids put into your veins with an IV.

Complications

Are there any complications from E. coli infection?

The most common complication is called hemolytic uremic syndrome. People with this problem get hemolytic anemia (which is a low red blood cell count), thrombocytopenia (which is a low platelet count) and renal failure (which is kidney damage).

Hemolytic uremic syndrome is more common in children. It can cause acute renal failure in children. This problem starts about 5 to 10 days after the diarrhea starts. People with this problem must go to a hospital for medical care.

Prevention

How can I keep from getting E. coli infection?

You can help prevent this infection by handling and cooking meat in a safe way. For your protection, follow these rules:

Wash your hands carefully with soap before you start cooking.

Cook ground beef until you see no pink anywhere.

Don't taste small bites of raw ground beef while you're cooking.

Don't put cooked hamburgers on a plate that had raw ground beef on it before.

Cook all hamburgers to at least 155°F. A meat thermometer can help you test your hamburgers.

Defrost meats in the refrigerator or the microwave. Don't let meat sit on the counter to defrost.

Keep raw meat and poultry separate from other foods. Use hot water and soap to wash cutting boards and dishes if raw meat and poultry have touched them.

Don't drink raw milk.

Keep food refrigerated or frozen.

Keep hot food hot and cold food cold.

Wash all fruits and vegetables, especially if eaten raw.

Refrigerate leftovers right away or throw them away.

People with diarrhea should wash their hands carefully and often, using hot water and soap, and washing for at least 30 seconds. People who work in day care centers and homes for the elderly should wash their hands often, too.

In restaurants, always order hamburgers that are cooked well done so that no pink shows.

Questions to Ask Your Doctor

How do I know what caused an E. coli infection?

How can I safely cook meat to prevent E. coli infection?

What are other ways besides undercooked ground beef that can cause E. coli infection?

If I think I have and E. coli infection what should I do and when should I call you?